Communication and health literacy in Dien Bien Province, Vietnam: experiences and perceptions of primary health care professionals and ethnic minority women

Abstract

Background: An important element of improving patient-centred communication in resource-poor settings is improving health literacy. There has been little research about communication and health literacy in such settings. Ethnic minorities in Vietnam experience poor communication with health professionals, and there are considerable inequities in health outcomes. This thesis aims to investigate the communication experiences, and the factors underlying communication, between ethnic minority women with limited health literacy and primary health care professionals in the maternal health setting in a remote province of Vietnam. Methods: This qualitative study used a focused ethnography methodology. Data was generated from in-depth interviews with health professionals (n=22) and focus group discussions with ethnic minority women (n=42). Results: Primary health services were likely to be underutilised and were perceived to be of low quality. Health professionals perceived communication to be a one-way path for delivering information and perceived communication problems to be due to patient factors, placing the burden for improvement on patients. Ethnic minority women experienced communication with health professionals as didactic and paternalistic, with health professionals often relying on written information. Discussion: This thesis adds new knowledge to the limited amount of research exploring health literacy and communication in low and middle-income countries. This research applies a health literacy lens to thinking patient/health professional communication, and how communication can be improved. There is evidence to suggest that patient-centred approaches to communication can be successfully implemented in Vietnam. Adopting more patient-centred approaches to health communication with women from diverse ethnic backgrounds in Vietnam could help to increase the use of maternal health services and reduce inequities in maternal health outcomes